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Vicodin (Hydrocodone/Acetaminophen) - What You Need to Know

Opiate Analgesic Used to Relieve Arthritis and Chronic Pain


Updated June 27, 2014

Written or reviewed by a board-certified physician. See About.com's Medical Review Board.

Vicodin tablets
DEA/Wikimedia Commons

Vicodin is the brand name of a pain medication that combines hydrocodone bitartrate and acetaminophen. The drug is also available in a generic version.

Vicodin is classified as a narcotic analgesic. It is not a new drug -- Vicodin was originally approved by the FDA in January 1983. For many people who live with arthritis or other chronic pain conditions, Vicodin is a mainstay in their pain management regimen. The drug has also received renewed attention since Darvon and Darvocet were removed from the market on November 19, 2010.

What is the availability of Vicodin?

Vicodin is only available by prescription. Vicodin comes in tablet form to be taken orally (by mouth). Each Vicodin tablet contains 5 mg hydrocodone bitartrate and 500 mg acetaminophen. There is also Vicodin-ES (7.5 mg hydrocodone bitartrate/750 mg acetaminophen) and Vicodin-HP (10 mg hydrocodone bitartrate/660 mg acetaminophen).

The usual adult dose of Vicodin (the 5/500 version) is one or two tablets every 4 to 6 hours as needed for pain. Total daily dosage should not exceed 8 tablets.

When is Vicodin prescribed?

Vicodin is prescribed to relieve moderate to moderately-severe pain. Researchers believe that the ingredient hydrocodone relieves pain by changing how the brain and nervous system respond to painful stimuli.

Are there any special instructions regarding how to take Vicodin?

The dosage of Vicodin should be adjusted according to your pain level, without exceeding the total allowable daily dosage. With continued use, a tolerance to Vicodin can develop, and with increased dosage, there may be increased side effects.

Are there patients who should not take Vicodin?

People who previously exhibited hypersensitivity to hydrocodone or acetaminophen should not take Vicodin.

What common side effects can occur with Vicodin?

Some of the common side effects that may be associated with Vicodin include:

  • Lightheadedness
  • Dizziness
  • Sedation
  • Nausea
  • Vomiting

There are also adverse events related to the central nervous system, gastrointestinal system, genitourinary system, respiratory system, the senses, and dermatology:

  • Central nervous system -- drowsiness, lethargy, cloudy thinking, impairment of mental and physical performance, anxiety, fear, dysphoria, mood changes, and psychic dependence
  • Gastrointestinal -- constipation with prolonged use
  • Genitourinary -- ureteral spasm, bladder sphincter spasm, urinary retention
  • Respiratory -- respiratory depression that is dose-related
  • Special senses -- hearing impairment or hearing loss related to chronic overdose
  • Dermatology -- skin rash, pruritis

What other special warnings and precautions apply to Vicodin use?

Vicodin should be used with caution in the elderly population and with debilitated patients, patients with severe liver or kidney impairment, hypothyroidism, Addison's disease, prostatic hypertrophy, or urethral stricture. It should always be remembered that there is the potential for respiratory depression and that Vicodin suppresses the cough mechanism.

Patients should use caution when driving and operating machinery while taking Vicodin. The drug can be habit-forming, so being cognizant of your dose will serve you well. If you require more and more to achieve the same therapeutic benefit, talk to your doctor.

Are there drug interactions associated with Vicodin?

There may be drug interactions with Vicodin and other narcotic analgesics, antihistamines, anti-psychotics, anti-anxiety medications, or other central nervous system depressants, including alcohol and sedatives. Your doctor may need to adjust your dose of Vicodin if you take any of these drugs.

Are there special instructions for pregnant or nursing women?

Vicodin should be used with caution by pregnant women. Vicodin use during pregnancy may lead to physical dependence or breathing problems in the newborn. Mothers who are breastfeeding should not use Vicodin since it is excreted in breast milk.

What are the signs of overdose of Vicodin?

Signs and symptoms of overdose include respiratory depression, extreme sleepiness that progresses to coma, skeletal muscle flaccidity (limpness), cold or clammy skin, bradycardia (slow heartbeat), and hypotension (low blood pressure). With very severe overdose, there can be apnea, circulatory collapse, cardiac arrest, and death. The acetaminophen portion of Vicodin can result in fatal hepatic necrosis, renal tubular necrosis, hypoglycemic coma, and thromocytopenia (low platelets).


FDA Panel Recommends More Restrictions on Vicodin and Other Hydrocodone Drugs

FDA Limits Acetaminophen in Prescription Combination Products Including Arthritis Painkillers


Vicodin. Abbott. Accessed 3/30/11. http://www.rxabbott.com/pdf/vicodin.pdf

Hydrocodone. MedlinePlus. 09/01/2010. http://www.nlm.nih.gov/medlineplus/druginfo/meds/a601006.html

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